Mirtazapine (Remeron) is the newest antidepressant medication available for clinical use in this country. Pharmacologically, mirtazapine results in enhanced noradrenergic neurotransmission, selective enhancement of 5HT1 mediated neurotransmission, and histaminergic blockade (Golden et al, in press). Mirtazaine's side effect profile is unique among the currently available anitdepressants: absence of anticholinergic effects and anxiolytic and sedative properties. The absense of anticholinergic effects and effects on EKG and cardiac function makes this medication potentially useful with patients with co-existent cardiovascular disease, However, mirtazapine has been linked to elevated plasma total cholesterol levels, with an average 3-4% increase in random cholesterol levels in one study (Davis and Wilde, 1996). It is difficult to interpret the meaning of random (non-fasting) cholesterol levels which would be expected to increase in relation to improved appetite and increased caloric intake as depression remits. Therefore, the purpose of this study is to more carefully evaluate the effect of mirtazapine on plasma cholesterol and triglyceride levels.